急性感染期与慢性感染期患者在ART前的HIV-1 DNA水平  

Trends of HIV-1 DNA in acute and chronic HIV infection before initiating ART

作　　者：彭爽 王敏 祁慧 余维维 曾紫微 PENG Shuang;WANG Min;QI Hui;YU Weiwei;ZENG Ziwei(Changsha Hospital Affiliated to University of South China,Hengyang 421000,China;The First Hospital of Changsha,Changsha 410000)

机构地区：[1]南华大学附属长沙医院,湖南衡阳421000 [2]长沙市第一医院,长沙410000

出　　处：《中国艾滋病性病》2022年第3期271-275,共5页Chinese Journal of Aids & STD

基　　金：国家“十三五”科技重大专项(2017ZX10202101-001-014)

摘　　要：目的明确急性感染期患者与慢性感染期患者在启动ART前的病毒储存库含量,探究急性感染期患者与慢性感染期患者之间HIV-1 DNA的差异性。方法纳入未启动ART的HIV感染者进行横断面研究,根据感染分期分为两组:急性感染期组(AHI组)及慢性感染期组(CHI组)。根据Fiebig临床分期,将AHI组再分为两组:FiebigⅠ~Ⅳ期及FiebigⅤ期。检测所有患者的CD4细胞、CD8细胞、HIV-1 RNA及外周血单个核细胞(PBMC)中的HIV-1DNA等。结果共纳入了97例HIV-1感染者,其中AHI组为50例,CHI组为47例。AHI组的HIV-1 DNA均值为2.83 lg copies/106PBMCs,CHI组的HIV-1 DNA均值为3.19 lg copies/106PBMCs,AHI组与CHI组的HIV-1 DNA均值比较差异有统计学意义(P=0.002),而两组的HIV-1 RNA差异无统计学意义(P=0.183)。AHI组中FiebigⅠ~Ⅳ期的患者有24例及FiebigⅤ期的患者有26例。FiebigⅠ~Ⅳ组的HIV-1 DNA均值为2.55 lg copies/106PBMCs,FiebigⅤ组的HIV-1 DNA均值为3.10 lg copies/106PBMCs,FiebigⅠ~Ⅳ组与FiebigⅤ组的HIV-1 DNA均值比较差异有统计学意义(P=0.001)。结论在启动ART前,急性感染期患者的HIV-1 DNA水平低于慢性感染期患者,因此急性感染期患者的病毒储存库更小,提示早期快速启动ART对患者更有利。在急性感染患者中,FiebigⅠ~Ⅳ期患者比FiebigⅤ期患者的HIV-1 DNA水平更低,揭示HIV-1患者的病毒储存库在急性感染早期已经建立。Objective To determine the level of HIV-1 DNA in the viral reservoir before ART in patients with acute infection and chronic infection and to explore the difference of HIV-1 DNA between patients with acute and those with chronic conditions.Methods A cross-sectional study was carried out in two groups of HIV-infected persons:the AHI(Acute HIV infection)Group and CHI(Chronic HIV infection)group.According to the clinical stage of Fiebig,the AHI Group was divided into two groups:Fiebig I-IV(Group A)and Fiebig V(Group B).All patients collected the results of CD4+T cells,CD8+T cells,HIV-1 RNA,and HIV-1 DNA in PBMC(Peripheral Blood Mononuclear Cell).Results A total of 97 HIV-1 infected patients were enrolled in this study,including 50 AHI Group and 47 CHI Group.The mean values of HIV-1 DNA in the AHI Group are 2.83 lg copies/106PBMCs,and those in the CHI group are 3.19 lg copies/106PBMCs.The mean values of HIV-1 DNA in the AHI Group and CHI Group are statistically different(P=0.002).There is no significant difference in HIV-1 RNA between the two groups(P=0.183).In the AHI Group,there are 24 patients with Fiebig I-IV and 26 patients with Fiebig V.The mean value of HIV-1 DNA in Group A is 2.55 lg copies/106PBMCs,and that in Group B is 3.10 lg copies/106PBMCs.HIV-1 DNA means of group Fiebig I-IV and group Fiebig V is statistically different(P=0.001).Conclusion Before initiating ART,HIV-1 DNA levels in patients with acute infection are lower than those in patients with a chronic condition,so the viral reservoir in patients with acute disease is smaller,which provides favorable evidence for promoting early treatment.In patients with acute infection,HIV-1 DNA levels are lower in patients with Fiebig I-IV than in patients with Fiebig V,and HIV-1 reservoirs are established in the early stage of acute infection.

关 键 词：艾滋病病毒脱氧核糖核酸 急性感染期 

分 类 号：R512.91[医药卫生—内科学]